Air Force Signing the HPSP Contract

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skiteflies123

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Hi guys! This is my first time posting, so I have no idea if I posted this in the right place. So, I have been accepted to a medical school and have been accepted for the HPSP scholarship. I have not yet signed by commission papers however, and am now starting to have doubts. When I first went to recruiting, I was somehow convinced that I would be able to do research and pursue any other extra things I wanted to do on top of my normal residency. My recruiter also told me that most likely I will get whichever location I would want to go. Now that I have started talking with more people, I am hearing that all of these are lies.

Can somebody please give me their experiences with the HPSP scholarship in terms of what it means to be a military doctor and if I will be restricted from doing certain research, residencies, or fellowships

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Hi guys! This is my first time posting, so I have no idea if I posted this in the right place. So, I have been accepted to a medical school and have been accepted for the HPSP scholarship. I have not yet signed by commission papers however, and am now starting to have doubts. When I first went to recruiting, I was somehow convinced that I would be able to do research and pursue any other extra things I wanted to do on top of my normal residency. My recruiter also told me that most likely I will get whichever location I would want to go. Now that I have started talking with more people, I am hearing that all of these are lies.

Can somebody please give me their experiences with the HPSP scholarship in terms of what it means to be a military doctor and if I will be restricted from doing certain research, residencies, or fellowships

If you join the military you obligate yourself to participate in the military match and train at a military hospital. They may or may not choose to allow you not to participate in the civilian match instead, but the decision is theirs, not yours. Its also not made on merit: they have no desire to put their best students into civilian residencies.

The match for military residencies is nothing that everyone else doesn't have to deal with. If you are the best and most charming student you get to go where you want to go, otherwise you go where you are told to go, just like a civilian in the civilian match. Where you work after residency will be determined entirely by the military. You will put in preferences and they will take them into consideration, but those preferences are considered in order of seniority and you will be the most junior guy. Sometimes people get lucky but odds are you will get to decide between a desert and a swamp.

The odds of getting any particular residency in the military vary enormously from year to year even when they aren't completely reorganizing the medical corps, which they currently are. We don't even know what specialties will exist in the military in 4 years, let alone what the odds of getting those specialties will be for a given student.

You will not be allowed to extend medical school and there is a good chance you will need to attend military training between MS1 and MS2, which limits your ability to do meaningful research. In residency you will have the resources you need for research (good library support, reasonable IRB, mentorship) but very few military residencies protect research time or allow the multiple protected research months that people need to bring a project through to completion. Your first duty station will likely have no research support at all. Some military physicians are quite productive in research early on despite having limited time devoted to it, and others carve out a niche in a big military hospital later in their career, but early on the emphasis is very much on direct patient care.

Please understand that once you sign the papers you cannot legally quit. From the day the school gets your first check you are obligated to serve out 4 years above and beyond your training. Don't sign unless you are sure.
 
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Please browse the forum there a bit. Agree with everything Perrotfish said here, and while you should take his word for it, you don’t have to do so. There are plenty of other experiences here as well.
 
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If you join the military you obligate yourself to participate in the military match and train at a military hospital. They may or may not choose to allow you not to participate in the civilian match instead, but the decision is theirs, not yours. Its also not made on merit: they have no desire to put their best students into civilian residencies.

The match for military residencies is nothing that everyone else doesn't have to deal with. If you are the best and most charming student you get to go where you want to go, otherwise you go where you are told to go, just like a civilian in the civilian match. Where you work after residency will be determined entirely by the military. You will put in preferences and they will take them into consideration, but those preferences are considered in order of seniority and you will be the most junior guy. Sometimes people get lucky but odds are you will get to decide between a desert and a swamp.

The odds of getting any particular residency in the military vary enormously from year to year even when they aren't completely reorganizing the medical corps, which they currently are. We don't even know what specialties will exist in the military in 4 years, let alone what the odds of getting those specialties will be for a given student.

You will not be allowed to extend medical school and there is a good chance you will need to attend military training between MS1 and MS2, which limits your ability to do meaningful research. In residency you will have the resources you need for research (good library support, reasonable IRB, mentorship) but very few military residencies protect research time or allow the multiple protected research months that people need to bring a project through to completion. Your first duty station will likely have no research support at all. Some military physicians are quite productive in research early on despite having limited time devoted to it, and others carve out a niche in a big military hospital later in their career, but early on the emphasis is very much on direct patient care.

Please understand that once you sign the papers you cannot legally quit. From the day the school gets your first check you are obligated to serve out 4 years above and beyond your training. Don't sign unless you are sure.

Thank you so much for your reply! I have a few questions if I may.

As a military physician, how different is it in practice from your civilian counterparts? Also, what are the chances that you will be deployed?

Ah, I see! So residencies are really a shot in the dark in terms of hoping that what you want to do lines up with what the military needs that year. Do you happen to know what the average amount of years is for a person to have to go unmatched/GMO tour before matching into the residency they want? Also, how do military residencies differ from civilian residencies in terms of training?

The information I got from my recruiter about extending medical school and doing research is different from what you and my friends have told me thus far, so thank you for clarifying that. I was originally looking at the potential of doing space medicine with the air force, but I was told recently that there isn't a lot of medical research in it yet, unlike the work done at NASA and some other medical institutes like Baylor college of medicine. Do you know what the outlooks are for the research in that field?

Yeah, this is why I wanted to make sure I read the contract fully. I want to make sure that I fully understand what I am getting into. If you don't mind me asking what was the deciding factor for you going into military medicine and is there anything you feel that you missed out on since you took that route?
 
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Thank you so much for your reply! I have a few questions if I may.

As a military physician, how different is it in practice from your civilian counterparts? Also, what are the chances that you will be deployed?

If you practice in a hospital military medicine is just a normal practice in a really dysfunctional clinic. Twice as much work as a civilian would put up with and the EMR doesn't work. You could, however, be shunted into an operational role (seeing active duty) which is more focused on adolescent medicine and occupational medicine than whatever you trained in, or you could even be sent to a primarily admin role.

Odds of being deployed depend entirely on the political situation. At the height of the Iraq war you would be lucky to only have one 9 month deployment. Now not a single person in my residency class has done an operational tour, let alone deployed. There is no limit to how much they can deploy you once you are in.


Ah, I see! So residencies are really a shot in the dark in terms of hoping that what you want to do lines up with what the military needs that year. Do you happen to know what the average amount of years is for a person to have to go unmatched/GMO tour before matching into the residency they want? Also, how do military residencies differ from civilian residencies in terms of training?

So again the military is being completely reorganized now. I can't really tell you what you'll be up against. When I trained about 60-75% of Navy physicians would do a 2-3 year GMO tour after intern year and most would be allowed to come back to residency. A smaller percentage of AF physicians would do flight surgery and most would not get to come back to military training. The Army did very few GMO tours, but far more first tour residency complete physicians were placed into operational roles. The key thing, though, is that they are reorganizing everything right now and no one can tell you what things will look like when you get there.

The information I got from my recruiter about extending medical school and doing research is different from what you and my friends have told me thus far, so thank you for clarifying that. I was originally looking at the potential of doing space medicine with the air force, but I was told recently that there isn't a lot of medical research in it yet, unlike the work done at NASA and some other medical institutes like Baylor college of medicine. Do you know what the outlooks are for the research in that field?

In general the military outsources their major research efforts to civilians. There are exceptions but they are rare, and its even more rare for that exception t be someone on their initial obligation. Assume that as a first tour AF physician that you will not be doing research on space medicine.

Yeah, this is why I wanted to make sure I read the contract fully. I want to make sure that I fully understand what I am getting into. If you don't mind me asking what was the deciding factor for you going into military medicine and is there anything you feel that you missed out on since you took that route?

I went to the second most expensive medical school in the country, wanted to do primarily clinical practice, went into the lowest paying specialty, and always had extremely romantic notions of the military and a strong desire to join. I still have no idea if it was the right decision. I had a lot of lucky breaks: trained at my top choice, no GMO tour, full scope of practice, good mentorship. Even still the duty station where I did payback was an absolute slog and being out feels just incredible by comparison.
 
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Recruiters are incentivized to say whatever it takes to get that signature. Even if you have an honest one who won’t, they literally have no idea what a doctor’s life is like
 
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Hi guys! This is my first time posting, so I have no idea if I posted this in the right place. So, I have been accepted to a medical school and have been accepted for the HPSP scholarship. I have not yet signed by commission papers however, and am now starting to have doubts. When I first went to recruiting, I was somehow convinced that I would be able to do research and pursue any other extra things I wanted to do on top of my normal residency. My recruiter also told me that most likely I will get whichever location I would want to go. Now that I have started talking with more people, I am hearing that all of these are lies.

Can somebody please give me their experiences with the HPSP scholarship in terms of what it means to be a military doctor and if I will be restricted from doing certain research, residencies, or fellowships

Don't count on being able to do research at your duty stations. You might be able to cobble something together, but the initiative will be yours, and you probably won't have any support.

The military services are in a transition, and availability of training is undetermined for some specialties, the present emphasis being in providing specialists and generalists of greatest importance in a warfare scenario. If you have read the past posts on the subject, those are the "bucket 1" group of specialties: surgery, orthopedic surgery, neurosurgery, and several other surgery specialties, psychiatry, emergency medicine, internal medicine and family practice and some IM specialties. If your interests lie outside these areas, the military's commitment may not be there to train you. So be forewarned.

You won't have any restrictions on your doing research while in medical school, but don't expect to be extended/deferred if you decide you want to change to a M.D./Ph.D. track that takes longer. They expect you to be done in four years and ready for internship then. As said above, if they want you to go to OIS in the M1-M2 summer, you have to comply.

As far as residency goes, it is way to soon for anyone to have an idea for you what will be available/allowed 4-7 years from now.
 
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I agree with the excellent advice you have been given above.

Military medicine is in the midst of a complete, top to bottom restructuring.

No one knows what mil med is gonna be like in 3+ years when you are applying for internship. Heck, I wouldn't trust a signed letter from the Surgeon General, because they don't even know what it will be like in 3 or 4 years.

I do agree that while the milmed talks about research, they don't walk that talk. If your heart is set on research after medical school, internship, or residency, signing on at this stage of your career is not a smart move IMO. Even during medical school may be a challenge.

HPSP was the best thing for me. But that was a long time ago.

And I am enjoying the reserves right now.

HPSP now? I just can't in good conscience recommend HPSP to someone with no .mil experience because there are just too many unknowns.



Can somebody please give me their experiences ...... if I will be restricted from doing certain research, residencies, or fellowships

To answer your question. Yes. Signing the dotted line gives the .mil control of most of your professional future. For some, it works out perfectly. For others, okay. And for some, it is a huge mistake they regret. You pays your money and you take your chances.



Congrats on your acceptance and good luck!
 
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Congrats on your acceptance and good luck!
Thank you! Do you know if I would still be able to do a service loan repayment with the military after becoming a doctor (if I am still interested)? A lot of people have mentioned this to be an option for me as well.
 
Thank you! Do you know if I would still be able to do a service loan repayment with the military after becoming a doctor (if I am still interested)? A lot of people have mentioned this to be an option for me as well.
Hplrp?
 
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Thank you! Do you know if I would still be able to do a service loan repayment with the military after becoming a doctor (if I am still interested)? A lot of people have mentioned this to be an option for me as well.

Yes. There are a number of programs with active duty, national guard, and reserve opportunities at every step of training.

The later you sign, the more information and 'control' you will have, and what your future looks like will be a bit clearer.

IMO, the later you commit, the better off you are.

Pretty good summary here:
 
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Will I have a harder time getting those other programs if I reject this scholarship though?
 
Will I have a harder time getting those other programs if I reject this scholarship though?
Because you declined the scholarship now? I doubt that would happen for that reason. What is unknown is what form recruiting will take for the .mil in eight or ten years when you have done a residency and maybe a fellowship and were applying then, for HPLRP or whatever programs might exist then. No one knows and no one can tell you with any certainty. Everything will depend on what the services will need then and what they can expect to have from their own active duty training pipeline at that time. Maybe you with your training will be exactly what they need and want, or maybe not.
 
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I always thought the military did a decent job at training pediatricians, or at least they tried. The exception was cross-departmental support, peds surgery, for instance. They had great people but did nothing to keep them around. Lots of them left for high ranking academic programs, as did the peds surgeon from my internship surgery program, off to UCLA with rafts of goodies and unlimited OR time to sweeten the deal.
 
So here is something that I am a little confused on, do most people go GMO or do they mostly get accepted to residency positions? I see lots of stories on SDN of GMO positions but I thought that going through residency was the norm. I am just beginning medical school as a DO and am looking at the HPSP. My desired residency options right now are EM, Anesthesia or psych. Would it be more likely that I go through residency (in the military) straight after medical school for those options or most likely go through a transitional year and then GMO before a civilian residency?
 
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